Breathing assistance device comprising a gas regulating valve and associated breathing assistance method

ABSTRACT

The invention relates to a breathing assistance device for a patient, the device including: a source of respiratory pressurised gas; a gas transmission duct comprising a distal end coupled to said source and a proximal end coupled to the patient; a gas regulating valve interposed in the gas transmission duct at a proximal location, comprising a leakage orifice and an obstruction means capable of varying the opening of the leakage orifice upon signal of controlling means and allowing a bidirectional gas flow through the leakage orifice in both expiration and inspiration phases.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 11/919,463, filed on Jun. 16, 2009, which application is anational phase entry under 35 U.S.C. §371 of International ApplicationNo. PCT/EP2006/061989 filed May 2, 2006, which claims priority fromPCT/IB2005/001454 filed May 2, 2005, all of which are herebyincorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to a breathing assistance device for apatient.

More precisely, the invention relates to a breathing assistance devicefor a patient breathing in successive respiratory cycles, eachrespiratory cycle being defined by at least an inspiration phase and atleast an expiration phase.

BACKGROUND OF THE INVENTION

A variety of breathing assistance devices, which we will also generallyrefer to as “respirators” in this text, are available today.

These respirators are equipped with a source of respiratory pressurizedgas. They are qualified as “autonomous” as an external pressurized gasfeeding is not required to operate them.

These devices provide the patient, at each inspiration, with arespiratory gas (typically ambient air to which a complementary gas suchas oxygen can be added).

Different types of respirators are known. These different types ofrespirators can be classified e.g. according to their size.

Indeed, the size of these devices is an important parameter: it isgenerally desirable to minimize this size, in order to facilitate theoperation of a same and single device in varied places and circumstances(e.g. home, as well as hospital), and in order to increase the mobilityof the patient.

Non-Transportable Devices

A first type of respirators relates to the ones qualified as beingnon-transportable. This first type is schematically illustrated in FIGS.1a to 1 d.

Such devices are generally equipped with a respiratory gas source S1having a very large size and/or weight. This gas source can be internalto the device, located in this case in a central unit 10, as thenon-transportable respirator described hereinafter and illustrated inFIGS. 1a to 1d . The gas source can also be external to the device.

In these devices, the source of gas is coupled to the patient P throughtwo ducts, an inspiration duct 11 dedicated to the inspiration phase andthrough which the patient P inspires the pressurized gas from the sourceof gas, and an expiration duct 12 dedicated to the expiration phase andthrough which the patient can exhale expiratory gases, such as carbondioxide.

These non-transportable respirators are further provided with aninspiratory valve 13 and an expiratory valve 14. These two valves arelocated close to the gas source S1, respectively on the inspiration duct11 and on the expiration duct 12.

The inspiratory valve 13 allows controlling the flux of the pressurizedgas transmitted to the patient during the respiratory phases.

The expiratory valve 14 allows the expiratory gases of the patient topass out of the expiratory duct 12, in the surrounding atmosphere. Forthis purpose, the expiratory valve can further be controlled with a PEP(Positive Expiratory Pressure).

Most of the operating modes of the respirators require a monitoring ofthe expiratory gas flow and/or expiratory pressure. Therefore sensor(s)19 for sensing the gas flow and/or pressure have to be provided in therespirator.

Each sensor usually needs to be connected to the central unit 10 of therespirator by at least three wires, in order to be supplied with powerand to convey data.

Therefore the sensors 19 are generally located near the gas source S1 inorder to avoid further increasing the complexity of the already quitecomplex and large double transmission circuit by the addition of sensorsand wires.

If it is desired that the sensors 19 are located in the vicinity of theexpiratory valve, said expiratory valve 14 has thus to be located closeto the gas source S1.

Both the inspiratory and expiratory valves require specific and oftencomplex controlling means 15, i.e. controller 15, in order to beoperated properly.

The non-transportable respirators are generally provided with relativelylong ducts, of about 150 to 180 cm.

This configuration results in a high breathing resistance whichincreases the work of breathing of the patient.

Indeed, if the expiratory valve 14 is located at the end of theexpiration duct 12 near the gas source S1 (distal end), and theexpiration duct 12 being relatively long, the patient P will need to“push” his expiration through the expiration duct 12 until the expiredair reaches the expiration valve to be vented to the atmosphere.

Transportable Respirators

A second type of respirators can be referred to as transportablerespirators, as schematically illustrated in FIGS. 2a to 2d . This typeof transportable respirator is provided with a central unit 20comprising an internal respiratory gas source S2.

The gas source S2 may be a small turbine or blower, having optimizedcharacteristics in order to limit the volume occupied by the device.

A further way to limit the volume of these devices is to use a singlegas transmission duct 21 between the source S2 and the patient P, incontrast with devices having two ducts (an inspiration duct and anexpiration duct).

The operation principle of these respirators is based on the use of anexpiratory valve 22 located on the single duct 21, near the patient P(i.e. at the proximal end of the duct).

Such proximal localization of this expiratory valve 22 allows, inparticular during the expiratory phase, to avoid the breathingresistance phenomenon which would be caused by the length of the ductused for expiration if the expiratory valve was located at the distalend of the duct.

In the known transportable respirators, such as represented in FIGS. 2ato 2d , this expiratory valve 22 is a pneumatic valve being operatedthanks to a pressurized air feeding conduit 23, coupled with therespiratory gas source S2 (or to another source of pressure such as anindependent microblower), and which inflates an obstructing cuff 24 ofthe expiratory valve 22.

Such control of the expiratory valve thus requires a specific conduit23, which limits the miniaturization of the respirator.

During the expiration phase, the expiratory valve 24 is either opened orpartially closed in order to establish a positive expiratory pressure(PEP) in the gas transmission duct to balance the residual overpressurein the patient lungs.

In order to establish such a PEP, it is necessary to control veryprecisely the pneumatic inflating pressure of the cuff 24 of theexpiratory valve 22. This increases the complexity of the controller 25of the respirator.

In some respiratory modes, the expiratory valve has to be operated asmuch as possible in real time, which is quite difficult in suchexpiratory valves because of the pneumatic inertias which are associatedwith them.

Moreover the configuration of such a known respirator imposes alimitation of the value of the PEP at around 20 mBar, while somerespiratory modes would need a higher value of the PEP (e.g. 40 mBar oreven more).

For the same reason as for non-transportable respirators, the expiratorygas flow and/or expiratory pressure may have to be controlled and gasflow and/or pressure sensors 29 have therefore to be provided near theexpiratory valve 22.

Here again this requires providing wires along the gas transmission duct21 between the central unit 20 containing the gas source S2 and thepatient P (namely three wires—two for power supply and one for datatransmission—for each pressure sensor, and two power supply wires foreach gas flow sensor). Since expiratory gas flow and pressure generallyhave to be measured, a connection cable 26 of at least five wires isthus required between the central unit 20 and the expiratory valve 22 atthe proximal end of the device.

Comment on Situation of Disabled Control of the Expiratory Valve

In order for the patient to safely use a respirator, the latter beingtransportable or not, this device must of course allow the patient tobreathe in any situation, including if the pressurized gas source isdisabled (breakdown or other). There are therefore safety standards tofulfil so that the breathing assistance device can work even if the gassource is disabled.

Thus, with a respirator having a single gas transmission duct 21 asdescribed before and a specific conduit 23 for pneumatic control of theexpiratory valve 22, the patient P can always expires through thepneumatic expiratory valve 22, even if the pneumatic feeding of theexpiratory valve 22 is disabled, as shown in FIG. 2 d.

Indeed, if the pneumatic feeding of the expiratory valve is disabled,(this being the case when the gas source is disabled, if the sourceprovides the control of the valve), the cuff 24 of the expiratory valve22 will not be fed anymore, preventing therefore the PEP control, butstill allowing the patient P to reject the expiratory gases E.sub.Pthrough the expiratory valve 22.

In such case, it will however be impossible for the patient P to inspirethrough this pneumatic expiratory valve 22, since the cuff 24 shallobstruct the passage between the inside and the outside of thetransmission duct 21, because of the patient inspiration I_(P).

Consequently, transportable respirators as illustrated in FIGS. 2a to 2dcomprise a safety back flow stop valve 27 near the gas source S2. Asrepresented in FIG. 2a , this safety valve 27 will normally be closedunder the effect of the pressure feeding G_(S) coming from the gassource S2, but if the latter is disabled, the pressure of the patientinspiration I_(P) will open the safety valve 27, allowing the patient Pto inspire air from outside, as illustrated in FIG. 2 c.

The disabling of the gas source S2 corresponds to a particular case ofdisabling of the pneumatic control of the expiratory valve 22. It isspecified that in this text such disabling of the gas source S2 isunderstood as more generally referring to a disabling of the pneumaticcontrol of the expiratory valve 22.

In order to allow a safe inspiration through the safety valve 27 and thewhole length of the duct 21, the diameter of the duct will have to belarge.

It is specified in this respect that there are generally pressure lossstandard requirements to fulfil for addressing this issue of safety. Forexample, the French standards state that the maximum pressure lossbetween the source and the patient must not exceed 6 hPa for 1liter•second for an adult and 6 hPa for 0.5 litre•second for a child.

And in order to fulfil such requirements, the transmission duct of knowndevices such as illustrated in FIGS. 2a to 2d must have a minimumdiameter of 22 mm for an adult and a minimum diameter of 15 mm for achild.

Such large diameter of the duct is of course an obstacle tominiaturization of the device.

For a non transportable respirator (see FIGS. 1a to 1d ), the patient Pwill always be able to expire through the expiration duct 12, even ifthe gas source S1 is disabled, as shown in FIG. 1 d.

If the gas source S1 is disabled, as illustrated in FIG. 1c , theinspiration phase is made possible through a safety back flow stop valve16 located on the inspiration duct 11, near the gas source S1.

This safety back flow stop valve 16 is not located on the expirationduct 12 as it would be dangerous for the patient P to inspire throughthe expiratory duct 12 which contains a plug of carbon dioxide.

For the same reasons as for the transportable respirators, the diametersof the duct must be relatively large to fulfil the pressure lossrequirements, that is a least 15 mm for children and 22 mm for adults,in order to allow a safe inspiration through the safety valve 16.

And here again, such large diameter is an obstacle to miniaturization.

Comment on Ability to Operate According to Different Modes

In addition, it is to be noted that the pathologies and diseases to betreated by the respirators are varied, and the breathing assistancedevices can therefore be of different types, such as pressure-controlledor volumetric-controlled, and be operated according to differentoperating modes.

Each operating mode is defined by particular setting and checkingvariables but also by a particular type of material.

Some devices, which can be referred to as hybrid, are able to workaccording to several operating modes. However their materialconfiguration, in particular the accessories (as the type of ductsbetween the gas source and the patient, the presence or not of anexpiratory valve, the use of a mask with apertures, etc.), must beadapted to the chosen operating mode. And it would be desirable tooperate a same and single device according to a large variety of modes,without requiring adapting the device (i.e. adapting its ducts,accessories, etc.).

Generally, it is an object of the invention to address one or more ofthe limitations and drawbacks mentioned above in this text.

BRIEF SUMMARY OF THE INVENTION

A first aspect of the invention is to allow miniaturization of arespirator device.

In one form of the invention the diameter of a duct between a source anda patient is reduced, while fully respecting the safety requirements.

It is a further aspect to provide a simple configuration. In one formthe number of wires between the central unit of the respirator and theproximal end of the duct is reduced.

Another aspect is to allow real-time control of the device. In one formof the invention real-time control of a gas regulation valve of a deviceis provided.

A further aspect of the invention is to allow multiple operating modeswithin a single respiratory device, without requiring adaptation of thedevice.

In one form the invention relates to a breathing assistance device asrecited in claim 1.

In particular, the invention concerns a breathing assistance device fora patient breathing in successive cycles, each cycle being defined by atleast an inspiration phase and at least an expiration phase, saidbreathing assistance device including:

-   -   a source of respiratory pressurized gas,    -   a gas transmission duct comprising a distal end coupled to said        source and a proximal end coupled to said patient,    -   a gas regulating valve comprising at least a leakage orifice        between the inside and outside of said duct, and an obstruction        element capable of varying the opening of said leakage orifice        upon signal of a controller,        characterized in that the gas regulating valve is interposed in        said duct at a proximal location, and that the obstruction        element is capable of allowing a bidirectional gas flow through        said leakage orifice in both expiration and inspiration phases.

Preferred but not limited aspects of such a breathing assistance deviceare the following:

-   -   the obstruction element is electrically controlled, and the        obstruction element may be an electromagnetic obstruction        element;    -   the obstruction element includes a return so that the leakage        orifice remains at least partially opened in the absence of        signal from the controller;    -   the return is a magnetic equator;        -   the electromagnetic obstruction element includes a metallic            sheath wherein a coil is fixed, said coil being controllable            by the controller and surrounding a movable magnetic            element, the metallic sheath and the movable magnetic            element defining the magnetic equator;        -   the magnetic element comprises a toric magnet, a first polar            piece and a second polar piece, said first and second polar            pieces being coaxially fixed on either side of the toric            magnet and being of different polarities, and said second            polar piece comprising an obstruction piece being capable of            obstructing the leakage orifice. The magnetic element is            translatable along an axis of revolution of the toric            magnet;        -   the electromagnetic obstruction element may include two            coaxial coils controllable by the controller, the first coil            substantially surrounding the toric magnet and the first            polar piece, and the second coil substantially surrounding            the toric magnet and the second polar piece;        -   the electromagnetic obstruction element is mounted coaxially            relative to the gas transmission duct;    -   the return is a compression spring;        -   the electromagnetic obstruction element includes an armature            surrounded by a coil, said coil being controllable by the            controller, and said armature comprising an inner toric            space wherein a magnetic element is translatable;        -   the magnetic element is capable of obstructing the leakage            orifice;        -   the magnetic element is constraint by the compression            spring;        -   the magnetic element comprises a toric magnet and a magnet            guide;        -   the electromagnetic obstruction element is mounted            transversally relative to the gas transmission duct.    -   the return is a rubber membrane;        -   the rubber membrane comprises a bellows designed for            maintaining the obstruction element in a position where the            leakage orifice is at least partially opened;        -   the bellows is designed for enhancing the returning function            if gas pressure within the valve increases;        -   the bellows has a convex curvature oriented towards walls of            the valve;        -   the obstruction element is at least partially confined            within an independent space from the duct.

Another aspect of the invention concerns a breathing assistance methodfor assisting a patient with a breathing assistance device of theinvention, as defined in claim 17.

In particular, it concerns a breathing assistance method for assisting apatient with a breathing assistance device according to the invention,characterized in that the leakage orifice is at least partially openedin the absence of signal from the controller.

Preferable but not limited aspects of such a breathing assistance methodare the following:

-   -   the leakage orifice is totally obstructed during inspiration        phases whereas it is a least partially opened during expiration        phases;    -   the leakage orifice, during expiration phases, is opened so that        positive expiratory pressure (PEP) remains equal to expiration        pressure of the patient;    -   the leakage orifice is totally opened in case of breakdown of        the source of respiratory pressurized gas.

The invention further relates to a gas regulating valve for a breathingassistance device, as recited in claim 25.

In particular, it relates to a gas regulating valve for a breathingassistance device, being interposed in a gas(transmission duct of saidbreathing assistance device at a proximal location, and comprising atleast a leakage orifice between the inside and outside of said duct, andan obstruction element capable of varying the opening of said leakageorifice upon signal of a controller, characterized in that the gasregulating valve is capable of allowing both an inward or an outward gasflow in both expiration and inspiration phases.

Preferable but not limited aspects of such a gas regulating valve arethe following:

-   -   the obstruction element includes a return so that the leakage        orifice remains at least partially opened in the absence of        signal from the controller;    -   the obstruction element is an electromagnetic obstruction        element including a metallic sheath wherein a coil is fixed,        said coil being controllable by the controller and surrounding a        translatable magnetic element, the magnetic element comprising a        toric magnet, a first polar piece and a second polar piece, said        first and second polar pieces being coaxially fixed on either        side of the toric magnet and being of different polarities, and        said second polar piece comprising an obstruction piece being        capable of obstructing the leakage orifice;    -   the obstruction element is an electromagnetic obstruction        element including an armature surrounded by a coil, said coil        being controllable by the controller, and said armature        comprising an inner toric space wherein a magnetic element is        translatable, the magnetic element being capable of obstructing        the leakage orifice and being constraint by a compression        spring.

The invention further relates to a gas regulating valve for a breathingassistance device, as recited in claim 29.

In particular, it relates to a gas regulating valve for a breathingregulating device, comprising at least a leakage orifice to theatmosphere and an obstruction element capable of varying the opening ofsaid leakage orifice upon signal of a controller, and passage meansbetween the valve and a pressurized gas source, characterized in thatsaid obstruction element can be moved between a position where it closessaid passage means and a position where it closes said leakage orifice.

The invention further relates to a gas regulating valve for a breathingassistance device, as recited in claims 30 and 31.

In particular, it relates to a gas regulating valve for a breathingassistance device, comprising a casing provided with at least a leakageorifice, an obstruction element capable of varying the opening of saidleakage orifice upon signal of a controller, and a processing portion(104) for connecting measurement means to the controller (35),characterized in that the processing portion is designed for beingremovably connected to the casing. The processing portion may namelycomprise a clip designed for surrounding the casing so that processingportion may be removably clipped on the casing.

BRIEF DESCRIPTION OF THE DRAWINGS

Other features and advantages of the invention will become clear fromthe following description which is only given for illustrative purposesand is in no way limitating and should be read with reference to theattached drawings on which, in addition to FIGS. 1a to 1d and 2a to 2dwhich have already been commented above:

FIG. 3 is a schematic representation of a breathing assistance deviceaccording to the invention;

FIG. 4a is a three-dimensional exploded view of a gas regulating valveaccording to a first embodiment of the invention;

FIG. 4b is a plan exploded view of the gas regulating valve of FIG. 4 a;

FIG. 4c is a side view of the gas regulating valve of FIG. 4 a;

FIG. 4d is a sectional view of the gas regulating valve of FIG. 4a witha closed leakage orifice;

FIG. 4e is a sectional view of the gas regulating valve of FIG. 4a withan opened leakage orifice;

FIG. 5a is a three-dimensional exploded view of a gas regulating valveaccording to a second embodiment of the invention;

FIG. 5b is a plan exploded view of the gas regulating valve of FIG. 5 a;

FIG. 5c is a side view of the gas regulating valve of FIG. 5 a;

FIG. 5d is a sectional view of the gas regulating valve of FIG. 5a witha closed leakage orifice;

FIG. 5e is a sectional view of the gas regulating valve of FIG. 5a withan opened leakage orifice;

FIG. 6a is a three-dimensional exploded view of a gas regulating valveaccording to a third embodiment of the invention;

FIG. 6b is a exploded plan view of the gas regulating valve of FIG. 6 a;

FIG. 6c is a side view of the gas regulating valve of FIG. 6 a;

FIG. 6d is a sectional view of the gas regulating valve of FIG. 6a witha closed leakage orifice;

FIG. 6e is a sectional view of the gas regulating valve of FIG. 6a withan opened leakage orifice;

FIG. 6f is an exploded sectional view of the gas regulating valve ofFIG. 6 a;

FIG. 7a is a schematic representation of a gas regulating valveaccording to the first and second embodiments of the invention, innormal operation, during the inspiration phase;

FIG. 7b is a schematic representation of a gas regulating valveaccording to the first and second embodiments of the invention, innormal operation, during the expiration phase;

FIG. 7c is a schematic representation of a gas regulating valveaccording to the first and second embodiments of the invention, when thecontroller is disabled;

FIG. 8a is a schematic representation of a gas regulating valveaccording to the third embodiment of the invention, in normal operation,during the inspiration phase;

FIG. 8b is a schematic representation of a gas regulating valveaccording to the third embodiment of the invention, in normal operation,during the expiration phase.

FIG. 9a is a three-dimensional exploded view of a gas regulating valveaccording to a fourth embodiment of the invention;

FIG. 9b is another three-dimensional exploded view of the gas regulatingvalve of FIG. 9 a;

FIG. 9c is a exploded plan view of the gas regulating valve of FIG. 9 a;

FIG. 9d is a sectional view of the gas regulating valve of FIG. 9a withan opened leakage orifice;

FIG. 9e is a partial sectional view of the return of the gas regulatingvalve of FIG. 9 a;

FIG. 10a is a three-dimensional exploded view of a gas regulating valveaccording to a fourth embodiment of the invention;

FIG. 10b is another three-dimensional exploded view of the gasregulating valve of FIG. 10 a;

FIG. 10c is a exploded plan view of the gas regulating valve of FIG. 10a;

FIG. 10d is a sectional view of the gas regulating valve of FIG. 10awith an opened leakage orifice;

FIGS. 11a-11f are different views of all or part of a regulating valvearrangement (herein called “active valve”) which can be said beincorporated in a breathing assistance device as mentioned above andillustrated in the preceding figures, but which is not limited to suchdevice.

DETAILED DESCRIPTION

Structure

General Structure of the Device

We shall first describe the general structure of a device (respirator)according to the invention. With reference to FIG. 3, a breathingassistance device according to the invention is shown in a schematicmanner.

This device comprises a central unit 30, which itself includes aninternal gas source S for supplying a patient P with respiratorypressurized gas. The gas source S is typically a small blower.

The breathing assistance device further comprises a gas transmissioncircuit between the central unit 30 and the patient P, so as to allowthe patient P to inspire and expire.

A gas regulating valve 32 is interposed in said gas transmission circuitat a proximal location. By proximal location, it has to be understoodthat the gas regulating valve 32 is located near (i.e. typically a fewcentimeters) the end of the gas transmission circuit coupled to thepatient P. As shall be described further in this text, the regulatingvalve can be made according to different embodiments (and it canfurthermore comprise a specific valve arrangement described in the“active valve” section).

The gas source S will preferably be capable of operating according toseveral respiratory modes.

This gas source is connected to an air inlet 33 a for collecting ambientair to be provided to the patient P.

An additional inlet 33 b may also be provided for a secondaryrespiratory gas such as oxygen, in order to enrich the ambient air.

The gas source S is powered through a power supply means, i.e. a powersupply 37. This power supply 37 means may be an internal battery or anexternal power supply.

The gas transmission circuit may be composed of one or more gastransmission ducts. As shown in FIG. 3, the breathing assistance deviceof the invention preferably includes a gas transmission circuitconsisting of a single gas transmission duct 31.

This gas transmission duct 31 comprises a distal end 31 d coupled to thesource S and a proximal end 31 p coupled to the patient P.

The proximal end 31 p of the transmission duct 31 is connected to thepatient P through a connecting means, i.e. a patient interface 36. Thispatient interface 36 may be e.g. a device adapted for tracheotomy or amask.

The breathing assistance device further includes a controller 35 forcontrolling the gas regulating valve 32 via a connection link 39 (fordata transmission and power supply). This connection link 39 can be aconnection cable 39.

The controller 35 is associated to measurement means, i.e. sensors 34(in particular a gas flow sensor and a pressure sensor).

More precisely, “associated to” means that the controller 35 eitherincludes such sensors 34, or is connected to them via a connection link.

Part or all of these sensor(s) can indeed be located proximally, that islocated near the gas regulating valve 32. It is also possible that partor all of these sensor(s) are located on the rest of the gastransmission duct 31, such as near its distal end 31 d.

The controller 35 further includes data processing means, i.e. dataprocessors, in particular to enable processing of the signals comingfrom the different sensor(s).

The data processors of the controller 35 are generally all located at adistal position, that is on the gas source S.

However, a data processor 38 may be located at a proximal position, thatis near the patient P. Indeed, the more sensors there will be near thegas regulating valve 32, the more wires there will have to be in theconnection cable 39 along the gas transmission duct 31, in order topower supply these sensors but also to collect the different emittedsignals.

It is therefore interesting to provide a proximal data processor 38 sothat the different signals from the sensor can be processed to betransmitted to distal data processor of the controller 35 through asingle data transmission wire. Such a configuration of the dataprocessor will therefore emphasize the miniaturization process, theconnection cable 39 between the distal data processing device and theproximal sensor needing only three wires, i.e. one data transmissionwire and two power supply wires.

The gas transmission duct 31 may be of different diameters. Inparticular, this gas transmission duct 31 may have a smaller diameterthan the ducts used in the known breathing assistance devices as thoserepresented in FIGS. 1a through 1d and 2a through 2 d.

The particular gas regulating valve 32 of the invention, interposed inthe gas transmission duct 31, enables namely to fulfil the pressure lossand safety standards without needing a minimal diameter duct. It istherefore possible for the gas transmission duct 31 to have a diametersmaller than 22 mm for adults and 15 mm for children.

The gas regulating valve 32 has indeed a structure that emphasizes theminiaturization of the breathing assistance device. In fact, the gasregulating valve 32 is electrically controlled no air feeding conduit isrequired leading thus to a more compact device. Further, as explainedabove, the gas transmission duct may be smaller than the usual ones.Finally, miniaturization of the breathing assistance device is increasedwhen using a data processor located on the gas regulating valve, i.e.proximally. As exposed further in this text, the breathing assistancedevice remains also highly safe and reliable.

First Embodiment of the Invention

The breathing assistance device according to a first embodiment of theinvention comprises a gas regulating valve as represented in FIGS. 4a to4e . The gas regulating valve 40 according to this embodiment of theinvention is mounted coaxially relative to the gas transmission duct 31.

The gas regulating valve 40 includes a casing made of three hollowportions, namely a distal portion 41, a central portion 42 and aproximal portion 43.

The three portions are coaxially connected together so as to form anintegral casing. Each portion is formed so that the casing comprises apassage through which the pressurized gas can circulate form the gassource S to the patient P and vice-versa.

The distal portion 41 and proximal portion 43 are formed to be connectedto the gas transmission duct 31, respectively in direction of the sourceS and the patient P.

The proximal portion 43 is provided with an aperture 431 so as to form aleakage orifice between the inside and the outside of the gas regulatingvalve 40. Gas may therefore leak from the gas transmission circuit tothe atmosphere and vice-versa. It is preferred that this aperture is aswide as possible, that is the aperture covers most of the circumferenceof the proximal portion 43.

The gas regulating valve 40 further includes an obstruction means, i.e.an obstruction element 44 in order to vary the opening of the leakageorifice. The obstruction element 44 is preferably an electromagneticobstruction element.

The obstruction element 44 includes a metallic toric sheath 441,preferably made of soft iron, wherein a coil 442 is fixed. This assemblyis fixed around the proximal portion 43 and is surrounded by the centralportion 42 of the casing.

The coil 442 may be a single toric coil but it is preferable to use twocoaxial toric coils, both surrounded by the toric sheath 441. The coil442 is powered by the controller 35 via the connection cable 39.

The obstruction element 44 further includes a magnetic elementcomprising a toric magnet 444, a first polar piece 443 and a secondpolar piece 445. The polar pieces are coaxially fixed on either side ofthe toric magnet 444, and are of different polarities. The polar pieceshave a rotational symmetry relative to the axis of revolution of thetoric magnet 444 and include a passage through which gas can circulatefrom the source S to the patient P and vice-versa.

This magnetic element is arranged within the proximal portion 43 and isat least partially surrounded by the coil 442. The magnetic element ismovable within the proximal portion 43, it is namely translatable alongthe axis of revolution of the toric magnet 444. This translationmovement is at least partially confined within the coil 442, the twoextreme positions being defined by abutments provided in the inner sideof the casing.

The magnetic element is provided with an obstruction piece 446 capableof obstructing the leakage orifice 431 of the proximal portion 43. Thisobstruction piece 446 is fixed on a polar piece of the magnetic elementand follows therefore the translation movement of the magnetic element.

Dimension and shape of the obstruction piece 446 depend on thecharacteristics of the leakage orifice 431 and the magnetic element. Theobstruction element 44 must namely be dimensioned so that theobstruction piece 446 totally closes the leakage orifice 431 when themagnetic element is positioned in one of its two extreme positions. Theobstruction piece 446 is also preferably made of a hard material.

The magnetic element is therefore composed of different pieces, whoseshapes and configuration allow a passage, through which gas cancirculate form the gas source S to the patient P and vice-versa.

Another arrangement of this embodiment of the invention would be to havean obstruction element including a fixed magnetic element, that is atleast a fixed magnet, and a movable coil, said movable coil beingprovided with an obstruction piece so as to be capable of obstructingthe leakage orifice of the proximal portion. Such arrangement may takethe form of the fourth embodiment described below.

Second Embodiment of the Invention

Another embodiment of a breathing assistance device according to theinvention comprises a gas regulating valve as represented in FIGS. 5a to5e . The gas regulating valve 50 of this second embodiment is verysimilar to the gas regulating valve 40 according to a first embodimentof the invention.

The gas regulating valve 50 of the second embodiment has namely the samestructure as the gas regulating valve 40 according to a first embodimentof the invention, in particular concerning the obstruction element.However, the gas regulating valve 50 comprises a proximal portion 53being provided with a housing 532 for sensor(s) connected to thecontroller 35 via the connection cable 39.

There is for example provided a gas flow pressure sensor (such as a hotwire sensor) and a pressure sensor. In this case the connection cable 39comprises at least seven wires. There will namely be needed two powersupply wires for the flow pressure sensor, two power supply wires and adata transmission wire for the pressure sensor, and two additional wiresto power supply the magnetic mechanism of the gas regulating valve 50.

Third Embodiment of the Invention

A third embodiment of a breathing assistance device according to theinvention comprises a gas regulating valve as represented in FIGS. 6a to6f . The gas regulating valve 60 according to this embodiment of theinvention is mounted transversally relative to the gas transmission duct31.

The gas regulating valve 60 comprises a casing 61 having a distal end611 and a proximal end 612, the distal end 611 being coupled to the gastransmission duct 31 in direction of the source S and the proximal end612 being coupled to the gas transmission duct 31 in direction of thepatient P.

The casing 61 has a shape very similar to a duct except the fact that italso includes a housing 613 for receiving an obstruction element 62.

A first aperture 614 is provided between the duct 616 of the casing 61and a first zone 6131 of the housing 613.

A second aperture 615 is provided in the first zone 6131 of the housing613, so that a gas flow may circulate between the inside of the casing61 and the outside.

The first and second apertures (614,615) thus define a leakage orifice617. Gas may circulate through this leakage orifice 617 from the gastransmission circuit to the atmosphere and vice-versa.

A cover 63 is foreseen to close the housing 613 and protect theobstruction element 62 disposed in a second zone 6132 of said housing613.

The obstruction element 62 is preferably an electromagnetic obstructionelement.

The obstruction element 62 comprises a metallic armature 622 which isfixed in the second zone 6132 of the housing 613. This armature 622 maybe made of soft iron. The armature 622 comprises a cylindrical passage6221 whose axis of revolution is perpendicular to the duct 616 of thecasing 61.

The armature 622 is preferably a revolution solid whose axis ofrevolution corresponds to the axis of revolution of the cylindricalpassage 6221. The armature 622 comprises a bottom disc 6222 having acircular opening at its centre and a top disc 6223 having a circularopening at its centre, the diameters of the bottom disc 6222 and of thecircular opening of the bottom disc 6222 being respectively larger thanthe diameters of the top disc 6223 and of the circular opening of thetop disc 6223.

Bottom and top discs (6222,6223) are coaxially coupled together througha peripheral coaxial cylindrical portion 6224 having the same diameteras the one of the bottom disc's circular opening.

A central coaxial cylindrical portion 6225 is provided in the armature622, between the bottom disc 6222 and the top disc 6223. This centralcoaxial cylindrical portion 6225 has the same diameter as the one of thetop disc's circular opening, and has an end fixed to the top disc 6223.

A central disc 6226 having the same diameter as the one of the centralcoaxial cylindrical portion 6225 is coaxially fixed to the other end ofthe central coaxial cylindrical portion 6225. This central disc 6226 isprovided with a circular opening at its centre.

In this configuration, the peripheral and central coaxial cylindricalportions (6224, 6225) of the armature 622 define a toric space 6227.

The obstruction element 62 further comprises a coil 621 that surroundsthe first cylindrical portion of the armature 622.

This configuration creates therefore an air-gap in the toric space 6227,between the coil 621 and the central coaxial cylindrical portion 6225 ofthe metallic armature 622, which is closed at one end with the top disc6223 of the armature 622.

The obstruction element 62 also includes a magnetic element, themagnetic element comprising a toric magnet 624 and a magnet guide 623.

The magnet guide 623 is a revolution solid comprising a bottom disc 6231and a top disc 6232 of a larger diameter, the top disc 6232 having acircular opening at its centre, the diameter of this opening being thesame as the diameter of the top disc. The bottom and top discs(6231,6232) are coaxially coupled through a peripheral coaxialcylindrical portion 6233 having a diameter identical to the diameter ofthe bottom disc 6231. A central coaxial cylindrical portion 6234 havinga smaller diameter is provided on the bottom disc 6231, between the topand bottom discs (6232,6231).

The toric magnet 624 has an inner diameter similar to the diameter ofthe first cylindrical portion 6233 of the magnet guide 623, so that themagnet guide 623 is inserted within the toric magnet 624.

The outer diameter of the toric magnet 624 is similar to the innerdiameter of the peripheral coaxial cylindrical portion 6224 of thearmature 622. The diameter of the circular opening of the top disc 6232of the magnet guide 623 is similar to the outer diameter of the centralcoaxial cylindrical portion 6225 of the armature 622. The centralcoaxial cylindrical portion 6234 of the magnet guide 623 has an outerdiameter similar to the diameter of the circular opening of the centraldisc 6226 of the armature 622. Therefore the magnetic element can becoaxially inserted within the toric space 6227 defined by the peripheraland central coaxial cylindrical portions (6224,6225) of the armature622.

The magnetic element is movable, it is namely translatable along theaxis of revolution of the armature 622, within the toric space 6227defined by the peripheral and central coaxial cylindrical portions(6224,6225) of the armature 622.

An annular ridge 6141 is provided within the housing 613 on theperiphery of the first aperture 614. The outer diameter of the toricmagnet 624 is larger than the diameter of the first aperture 614.Therefore the translation movement of the magnetic element is confinedbetween the armature 622 and the first aperture 614. More precisely themagnetic element abuts against the armature 622 in a first extremeposition (see FIG. 6e ) and against the annular ridge 6141 of the firstaperture 614 in a second extreme position (see FIG. 6d ).

In the second extreme position (see FIG. 6d ), the magnetic element ofthe obstruction element 62 totally closes the first aperture 614 andthus prevents any gas flow between the duct 616 of the gas regulatingvalve 60 and the housing 613. As a consequence, in this second extremeposition, no gas can circulate between the inside and the outside of thegas regulating valve 60.

In this configuration of the obstruction element 62, the magneticelement translates within the toric space 6227 depending on the state ofthe coils 621 controlled by the controller 35.

The obstruction element 62 further comprises a spring 626 having anouter diameter similar to the inner diameter of the central coaxialcylindrical portion 6225 of the armature 622, and which is insertedwithin said central coaxial cylindrical portion 6225 of the armature622. The spring 626 is preferably a compression spring.

The spring 626 is maintained within the central coaxial cylindricalportion 6225 of the armature 622 with a screw 627 which is screwedwithin the central coaxial cylindrical portion 6225 of the magnet guide623. The spring 626 has namely an end abutting against the head of thescrew 627 and another end abutting against the central disc 6226 of thearmature 622.

The gas regulating valve 60 may comprise a protection element 625 withinthe housing 613 of the casing 61. This protection element 625 delimitsthe first and second zones within the housing 613, the first zone 6131wherein the first and second apertures (614,615) are located and thesecond zone 6132 containing the obstruction element 62.

The protection element 625 is gas impermeable and prevents therefore gaswithin the duct of the gas regulating valve 61 from polluting theobstruction element 62.

The protection element 625 may be a rubber membrane. This membrane is arevolution solid comprising a central disc 6251, this central disc 6251having a relatively large peripheral and circular groove 6252.

The peripheral edge of the protection element 625 is pressed by thearmature 622 against a circular abutment between the first and thesecond zone of the housing 613. The annular ridge 6228 of the armature622 prevents the peripheral edge of the protection means 625 frommoving.

Another arrangement of this embodiment of the invention resides in anobstruction element comprising a magnetic element being fixed, that isat least a magnet being fixed, and a movable coil, said movable coilallowing the obstruction of the leakage orifice.

The housing 613 may comprise a third zone 6133 for receiving sensor(s)65 such as gas flow and/or pressure sensors for measuring gas flowand/or pressure in the duct of the gas regulating valve 60.

The sensor(s) 65 may be directly connected to the controller 35 locatedon the source S, via the connection cable 26. In this case, theconnection cable 39 is provided with a least seven wires (two powersupply wires for the flow pressure sensor, two power supply wires and adata transmission wire for the pressure sensor, and two additional wiresto power supply the magnetic mechanism of the gas regulating valve).

Therefore, a processing means 64 is preferably provided between thesensor(s) 65 and the connection cable 39. This processing means 64 islocated within the housing 613 and lies on both the sensor(s) 65 and theobstruction element 62.

The processing means 64 is connected to both the sensor(s) 65 and theobstruction element 62. Thus the processing means 64 allows thesensor(s) 65 and the obstruction element 62 to be power supplied.Moreover the processing means 64 is capable of managing the data fromthe sensor(s) 65 in order to precisely control the obstruction element62. The processing means 64 is capable of controlling the PEP, inprocessing the data from the sensor(s) 65 and operating the obstructionelement 62 in consequence.

The connection cable 39 between the processing means 64 and thecontroller 35 is also much simpler, being provided only with threewires, i.e. two power supply wires and one data wire.

The control of the gas regulating valve 60 being totally operated by theprocessing means 64, the controller 35 located in the central unit 30may also be simplified, if not totally removed. This thus contributes tothe miniaturization of the breathing assistance device.

Fourth Embodiment of the Invention

A fourth embodiment of a breathing assistance device according to theinvention shall now be described.

In this embodiment, the regulating valve is—like in all otherembodiments—in a proximal location near the patient.

In addition to the advantages already exposed about the invention, thisembodiment allows in particular:

-   -   offering particular high performance for avoiding leakage of gas        (e.g. between internal walls of inner elements of the valve),        while at the same time allowing a coaxial configuration, where        the main elements of the valve are aligned around the        longitudinal axis of the duct (this type of configuration tends        to decrease the size of the valve and hence increase capacity),    -   allowing excellent performance in terms of control of the        valve—in particular real-time control—since in the specific        configuration of such valve the moving parts have less inertia        and their quick and accurate displacement is facilitated,    -   furthermore allowing smooth operation of the valve with the use        of an elastic membrane having among its functions a function of        smoothly restoring a reference position of the moving parts of        the valve.

This fourth embodiment comprises a gas regulating valve as representedin FIGS. 9a to 9e . The gas regulating valve according to thisembodiment of the invention is mounted coaxially relative to the gastransmission duct 31. According to this embodiment of the invention theobstruction element includes a fixed magnetic element with a fixedmagnet, and a movable coil, said movable coil being provided with anobstruction piece so as to be capable of obstructing a leakage orificeprovided in a proximal portion of the expiratory valve.

The gas regulating valve 90 includes a casing made of two hollowportions, namely a distal portion 91, and a proximal portion 93 (asillustrated in particular on FIG. 9c ).

These two portions are coaxially connected together so as to form anintegral casing. Each portion is formed so that the casing comprises apassage through which the pressurized gas can circulate form the gassource S to the patient P and vice-versa.

The distal portion 91 and proximal portion 93 are formed to be connectedto the gas transmission duct 31, respectively in direction of the sourceS and the patient P.

The proximal portion 93 is provided with an aperture 931 so as to form aleakage orifice between the inside and the outside of the gas regulatingvalve 90. Gas may therefore leak from the gas transmission circuit tothe atmosphere and vice-versa. It is preferred that this aperture is aswide as possible, that is the aperture covers most of the circumferenceof the proximal portion 93.

The gas regulating valve 90 further includes an obstruction element 92in order to vary the opening of the leakage orifice. The obstructionelement 92 is preferably an electromagnetic obstruction element.

In the example illustrated in FIG. 9, the obstruction element 92comprises a metallic armature 922 which is fixed coaxially within thedistal portion 91. This armature 922 may be made of soft iron.

The armature 922 is preferably a revolution solid whose axis ofrevolution corresponds to the axis of revolution of both proximal 93 anddistal 91 portions. The armature 922 comprises two coaxial cylindricalportions, namely an inner cylindrical portion 9221 having a smallerdiameter than an outer cylindrical portion 9222.

These two cylindrical portions 9221 and 9222 are coupled together withan annular portion 9223 located on the proximal side of the armature.The annular portion 9223 is provided with a plurality of apertures, eachaperture having preferably the form of a curved slot.

The proximal end of the outer cylindrical portion 9222 may be providedwith an annular ridge 9224 for maintaining the obstruction piece(925,926,927) of the obstruction element 92 (described below) pressedbetween the armature 922 and the proximal portion 93.

The obstruction element 92 further includes a magnetic elementcomprising a toric magnet 924 and a toric metallic piece 923.

Both the toric magnet 924 and the toric metallic piece 923 have an innerdiameter similar to the outer diameter of the inner cylindrical portion9221. The toric magnet 924 and the toric metallic piece 923 bothsurround the inner cylindrical portion 9221 of the armature 922, in afixed manner.

The outer diameter of the toric magnet 924 and the toric metallic piece923 is smaller than the inner diameter of the outer cylindrical portion9222, thus creating a toric space 9225 within the armature 922. There istherefore an air-gap within the toric space 9225, between the toricmagnet 924 and the outer cylindrical portion 9222 of the metallicarmature 922, which is closed at one end with the annular portion 9223of the armature 922.

The obstruction element 92 further includes a movable coil 921 adaptedto be inserted within the toric space 9225, and to be coaxiallytranslatable therein.

The movable coil 921 is preferably a revolution solid whose axis ofrevolution corresponds to the axis of revolution of the armature 922.The movable coil 921 comprises a bottom disc 9211 having a circularopening at its centre and a top disc 9212 having a circular opening atits centre. The diameters of the circular opening of the bottom 9211 andtop 9212 discs are both similar to the outer diameter of the toricmagnet 924. The outer diameter of the top disc 9212 is similar to theinner diameter of the outer cylindrical portion 9222 of the armature922, so that the top disc 9212 can translate within the toric space9225. The outer diameter of the bottom disc 9211 is larger than theinner diameter of the outer cylindrical portion 9222 of the armature922, so that the bottom disc 9212 may abut against the armature 922 tolimit the translation movement of the coil 921.

Bottom 9211 and top 9212 discs are coaxially coupled together through acoaxial cylindrical portion 9213 having the same diameter as thecircular openings of the discs.

Top disc 9212 is provided with a plurality of projecting portions 9214around its circular opening. Each projecting portion 9214 issubstantially flat and curved with the same curvature as the cylindricalportion 9213 so as to lengthen this latter. Further, each projectingportion 9214 is provided with a ridge 9215 at its proximal end, thisridge 9215 enabling coupling of the movable coil 921 with theobstruction piece (925,926,927).

The obstruction piece comprises an elastic membrane 925 (made of rubberor silicone for example) and a pusher element 927 that is adapted fordeforming the membrane 925 depending on the translation of the coil 921within the toric space 9225.

The membrane 925 is relatively resilient and is adapted to obstruct theleakage orifice 931 of the proximal portion 93 when the coil 921 istranslated towards the proximal portion. The membrane 925 may be arevolution solid comprising an annular portion 9251, this annularportion 9251 having a relatively large peripheral and circular groove9252, which is oriented proximally. The peripheral edge of the annularportion 9251 is maintained pressed between the proximal portion 93 andthe outer cylindrical portion 9222 of the armature 922.

The membrane 925 is further provided with a cylindrical portion 9253having a similar diameter to the inner diameter of the annular portion9251. This cylindrical portion 9253 is provided with an annular ridge9254 for coupling the pusher element 927 to the membrane 925.

Finally the membrane 925 comprises a bellows 9255 extending from thecylindrical portion 9253 and comprising an annular ridge 9256 (notvisible in FIG. 9e ). This annular ridge 9256 enables the inner edge ofthe membrane 925 to be maintained on the armature 922 with a toricelement 926 for example.

Using such a rubber membrane 925 allows absorption of the shocks thatthe gas regulating valve may undergo while the obstruction piece ismoving.

Further, the particular form of the membrane 925, and in particular ofthe bellows 9255, in addition to its resilience, implies that themembrane 925 works as a return means, i.e. a return, for the coil 921.In particular, as will be explained in detail below, the membrane 925will prevent the leakage orifice 931 to be obstructed in case operationof the coil 921 is not working correctly.

Such a membrane could also be used for other embodiments, such as atransversally mounted gas regulating valve similar to the thirdembodiment. Indeed, this specific membrane could be used as a returninstead of the spring.

As described above, the pusher element 927 is adapted for deforming themembrane 925 on translation of the coil 921. Preferably, the pusherelement 927 comprises an annular flat portion 9271 with a curvedperipheral edge 9272. The curved peripheral edge 9272 is adapted tocooperate with the ridges 9215 of the projecting portions 9214 of thecoil 921 so that the pusher element 927 is engaged with the coil 921.The annular flat portion 9271 is adapted to cooperate with the annularportion 9251 of the membrane 925. More precisely it enables deformationof the membrane 925, and particularly of the groove 9252 and of thebellows 9255, upon movement of the coil 921 within the toric space 9225.

This particular embodiment of the valve, and in particular thearrangement of the obstruction element within the valve, increases itsreliability. Indeed, the movable coil is confined within a dedicatedspace which is separated from the passage of the valve through whichpressurized gas circulates from the source to the patient. Therefore,this arrangement prevents undesired leakages which might happen betweenthe movable element and the inner wall of the passage if the movableelement were located inside the passage.

The gas regulating valve may further be adapted for receiving sensor(s)95 such as gas flow and/or pressure sensors for measuring gas flowand/or pressure in the duct of the gas regulating valve 90.

To this end the distal portion 91 is provided with an external chamber912 provided with apertures through which the sensor(s) 95 may beplugged. The active portion of the sensor is thus located within the gasduct of the valve.

The sensor(s) 95 may then be directly connected to the controller 35located on the source S. However, similarly to the third embodiment, aprocessing means 94 is preferably provided between the sensor(s) 95 andthe connection cable 39.

To this end, the distal portion 91 is further designed to receive theprocessing means 94. In this case the distal portion 91 will need to belarger to be able to receive the processing means 94. A cover 911 is inthis case foreseen to close the distal portion 91 and protect both thesensor(s) 95 and the processing means 94.

Fifth Embodiment of the Invention

A variant of the invention shall now be described, in particular as anevolution of the valve described above in reference to FIG. 9.

This variant is presented as a separate—and thus fifth—embodiment of theinvention since it implies a particular configuration of the valveassembly as a modular assembly made of distinct modules.

This modular configuration can also be used with a valve different fromthe valve more specifically illustrated in FIG. 10, and thisconfiguration provides by itself a number of specific advantages whichshall be mentioned in the present section.

For providing the gas regulating valve 90 with a processing means suchas means 94 of FIG. 9 it is indeed possible to use an independentprocessing module 104, as illustrated more specifically in FIG. 10 c.

FIGS. 10a to 10d represent a gas regulating valve 100 according to afifth embodiment of the invention, this valve having an obstructionelement similar to the obstruction element of the expiratory valve 90but which is enclosed in a modular casing.

Similarly to the fourth embodiment, the gas regulating valve 100includes a casing made of two hollow portions, namely a distal portion101, and a proximal portion 103.

Again, these two portions are coaxially connected together so as to forman integral casing. Each portion is formed so that the casing comprisesa passage through which the pressurized gas can circulate form the gassource S to the patient P and vice-versa.

However, contrary to the fourth embodiment, the distal portion 101 ismore compact. Indeed, the distal portion 101 is designed to receive onlythe obstruction element 102. If the sensor 105 may be plugged on thedistal portion 101, there is no space provided for receiving connectionsto the controller 35, or any processing means. Therefore, if nomeasurement is needed, the gas regulating valve remains very compact andreliable.

In case measurements of the gas flow and/or pressure in the duct of thegas regulating valve are needed, an independent processing module 104may be connected to the valve. This processing module is designed to beremovably connected on the casing, that is the processing module is anindependent module that may be mounted directly and easily on the casingif measurements are needed. The processing module may for example bedesigned to be clipped on the distal portion 101 for example.

The processing module 104 may comprise a support means 1041 providedwith clipping means 1042 designed for surrounding the distal portion 101and maintained the processing module engaged around the distal portion101. The support means 1041 is further adapted for supporting aprocessing means 1044 thereon. An aperture 1043 through the supportmeans 1041 is also foreseen so that the processing means 1044 may beconnected to the sensor 105 plugged on the distal portion 101.

Finally, a cover 1045 encloses the processing means 1044 on the supportmeans 1041 to protect it. An aperture is also provided through the cover1045 to connect the processing means 1044 to the controller 35.

Not only this gas regulating valve has the advantage of being compact,the modular arrangement is also very advantageous in terms ofmaintenance.

The valve being intended to be used mostly for medical applications, thevalve must be adapted for sterilization processes, with an autoclave forexample. More precisely, each element that may have been polluted by thegas flow must be adapted for sterilization. This is the case of thedistal portion 101, the obstruction element 102, the proximal portion103, and eventually the sensor 105. Indeed, the processing module 104 iscompletely independent from the gas flow passage which means that itdoes not need to be autoclaved contrary to the other elements. This isparticularly advantageous as it would be particularly difficult andexpensive to manufacture an autoclavable processing module 104, and moreparticularly an autoclavable processing means 1044. It would namely beexpensive to have a processing means 1044 with autoclavable components.Further, the connections and particularly the connection between theprocessing means 1044 and the controller 35 may not withstand anautoclave curing.

A further advantage of having an independent processing module is thatit may be removed from the valve as a single unit, thus preventing anydamages of the processing module 1044 or of the connections.

Sixth Embodiment of the Invention

In reference now to FIGS. 11a to 11f , a valve arrangement which can beused in accordance with the invention shall now be described.

This valve arrangement can in particular be used in a regulating valvein a breathing assistance device as mentioned above and generallyillustrated in FIG. 3.

However such valve arrangement constitutes in itself a specific featurewhich can be used in different valve and/or device configurations.

An example of a very compact breathing assistance device 110 isillustrated in FIG. 11f , with:

-   -   a blower 111 (in fact a compressor blower, but generally called        a “blower”) for feeding a patient with compressed air (the        blower being possibly provided with an inlet for a secondary gas        such as oxygen),    -   a valve housing 112, sealingly attached to the outlet 1110 of        the blower by its first end 1121,    -   a valve 113, arranged into the valve housing and having an        outlet 1131 which can be directly put in contact with the        patient (i.e. the patient breathes directly at outlet 1131).

FIG. 11a illustrates in an exploded view the elements of the valve 113.

These elements are arranged coaxially, aligned around the axis A of thevalve housing 112 (which is typically itself aligned with the outlet ofthe blower).

On the exploded view of FIG. 11a , these elements are, from the proximalend of the valve (side opposed to the valve housing) to its distal end(side close to the valve housing):

-   -   the outlet 1131 which is on a hollow valve body 1132,        -   the valve body 1132 has two stages of coil 11321 and 11322            aligned in sequence along the axis A    -   a spring 1133,    -   a cylinder 1134, made of a material such a plastic, adapted to        be light (since this cylinder has to be easily moved), adapted        to be engaged in the central cavity of the valve body,    -   another cylinder 1135 in a material such as iron, and having an        inner diameter corresponding to the outer diameter of the valve        body 1132 with its coils,    -   an assembly 1136 made of a permanent magnet 11360 axially        surrounded by two iron cylinders 11361 and 11362, all three        items forming a single assembly 1136 made of one piece. This        assembly is hollow and has the general shape of a ring since all        its components have a central axial hole,    -   an O-ring 1137,    -   a ring 1138 called a flow-path ring, since it is provided with        holes 13380 disposed regularly around its central axis, for        letting the flow of gas circulate through, (these holes 11380        are separated by radial arms which join a central part of the        flow-path ring 11381 to its periphery 11382—these arms are not        visible on the figure). The number of holes can be adapted (e.g.        two, three, or more holes disposed regularly around the        periphery of the central part—or even a single hole),        -   the outer diameter of the central part of the flow-path ring            corresponds to the inner diameter of the assembly, with a            tolerance allowing relative movement of these two elements            along the axis A,        -   and the distal end of the assembly 1136 has a width which is            adapted to close the holes 11380 of this flow-path ring,            -   more precisely, once the elements are mounted together,                the flow-path ring 1138 is sealingly mounted inside the                distal end of the valve body, so as to define an inner                channel 11350 having the shape of a ring in regard of                the holes 11380, said channel being between the inner                wall of the valve body and the outer wall of the central                part of the flow path ring (see FIG. 11b ),            -   and the width of the assembly 1136 is the same as the                width of the channel 11350, with a tolerance to allow                longitudinal sliding of said assembly into this channel,    -   a sensor 11385 for sensing flow and/or pressure, e.g. a hot-wire        sensor. This sensor is disposed on an axial arm attached to the        proximal end of the central part 11381 of the flow-path ring, so        as to be placed on the axis A when the device is mounted.

FIG. 11b shows that these elements form two main parts once they aremounted together:

-   -   a fixed part comprising:        -   the valve body with its coils,        -   said coils being surrounded by the iron cylinder 1135,        -   the flow path ring 1138 with its arm and sensor 11381, said            flow path ring being mounted at the distal end of the valve            body so that when said valve body is mounted inside the            valve housing 112, any air coming from and going to the            blower has to flow through the holes 11380,            -   said flow path ring 1138 being furthermore provided with                a distal deflector for smoothly deflecting the air from                the blower towards the holes 11380,    -   and a moving part comprising the following elements attached        together:        -   the assembly 1136 (adapted as mentioned above to axially            slide inside the channel 11350 so as to sealingly close this            channel),        -   the cylinder 1134,        -   the spring 1133            -   said spring being is designed to abut against an inner                shoulder 11323 of the valve body so as to push the                moving part towards the distal end of the fixed part                when said spring is compressed because the moving part                has been displaced towards the proximal end of said                fixed part.

Operation of the Device

The breathing assistance device according to the invention is capable ofbeing operated even if the gas source S and/or the controller 35 aredisabled (e.g. in case of a breakdown).

We shall describe the operation of the breathing assistance device indifferent cases, as illustrated in FIGS. 7a to 7c and FIGS. 8a to 8 b.

Normal Operation

The normal operation of the device corresponds to the case when both thegas sources S and the controller 35 operate normally.

During the inspiration phase, the obstruction element (72;82) of the gasregulating valve is an extreme position so that the leakage orifice(71;81) of the gas regulating valve is totally obstructed, asillustrated in FIGS. 7a and 8 a.

As a consequence, when the patient P inspires, the pressurized gas G_(S)coming from the gas source S is transmitted to the patient P. Theleakage orifice (71;81) of the gas regulating valve being namely closed,the pressurized gas G_(S) can circulate in the gas transmission ductuntil the patient P.

FIGS. 4d and 5d represent the gas regulating valve (40;50) according tothe first and second embodiments of the invention during the inspirationphase, that is when the leakage orifice (431;531) is totally closed.

In this case, the controller 35 operates the coil (442;542) of theobstruction element (44;54) so that the magnetic element translateswithin the proximal portion (43;53) of the gas regulating valve (40;50)and abuts against an abutment provided within the proximal portion(43;53) of the gas regulating valve (40;50).

Therefore the obstruction piece (446;546) of the magnetic elementtotally closes the leakage orifice (431;531). The passage between theinside and the outside of a gas regulating valve (40;50) is thus closedand the pressurized gas coming from the gas source S only circulatesfrom the distal portion (41;51) to the proximal portion (43;53) and thento the patient P.

Operation of the gas regulating valve according to the fourth and fifthembodiments is similar. The difference resides in the location of theobstruction element and particularly of the movable element which movesin a separate space.

FIG. 6d illustrates the gas regulating valve 60 according to the thirdembodiment of the invention during the inspiration phase, that is whenthe leakage orifice 617 is totally closed.

In this case the controller 35 operates the coil 621 of the obstructionelement 62 so that the magnetic element translates until it abutsagainst the annular ridge 6141 of the housing 613.

Therefore the leakage orifice 617 is closed and no gas can circulatebetween the inside and the outside of the gas regulating valve 60. Themagnetic element namely obstructs the passage provided through the firstaperture 614 of the housing 613. In this situation, the pressurized gasG_(S) coming from the gas source S has no other way but to reach thepatient P.

During the expiration phase as illustrated in FIGS. 7b and 8b , theleakage orifice (71;81) is at least partially opened. The obstructionelement (72;82) has namely a position so that the gas flow can circulatebetween the inside and the outside of the gas regulating valve throughthe leakage orifice (71;81).

In this case, the patient P rejects expiratory gases E_(P) that have tobe evacuated. The leakage orifice (71;81) of the gas regulating valveallows such an evacuation of the expiratory gases.

Controlling the opening of the leakage orifice (71;81) with theobstruction element (72;82) of the gas regulating valve is also a way ofcontrolling the PEP. The PEP in the gas transmission duct is namelyimportant for the patient P to expire correctly, as the PEP is a way tobalance the residual overpressure in the patient lungs.

The obstruction element being electrically controlled, the control ofthe opening of the leakage orifice is a real time process.

FIGS. 4e and 5e illustrate the gas expiratory valve (40;50) according tothe first and second embodiments of the invention, during the expirationphase.

These figures namely show gas regulating valves having a leakage orifice(431;531) totally opened. The obstruction element (44;54) has indeedbeen operated by the controller 35 through the coil (442;542) so as totranslate until an abutment provided on the distal portion (41;51) ofthe gas regulating valve (40;50).

Operation of the gas regulating valve according to the fourth and fifthembodiments is similar.

FIG. 6e illustrates a gas regulating valve 60 according to the thirdembodiment of the invention during the expiration phase.

This figure namely shows a leakage orifice being totally opened. Infact, the magnetic element of the obstruction element 62 has beenoperated by the controller 35 through the coil 621 in order to translateuntil abutting against the armature 622.

In this position, the first aperture 614 between the duct 616 and thehousing 613 of the gas regulating valve is wildly opened. A gas flow cantherefore circulate between the duct 616 of the gas regulating valve 60and the housing 613, this gas flow being then able to circulate from thefirst zone of the housing 613 to the outside of the gas regulating valve60 through the leakage orifice 617.

It is to be noticed that the opening of the first aperture 614 betweenthe duct 616 and the housing 613 of the gas regulating valve 60 can beprecisely controlled in translating the magnetic element of theobstruction element 62.

Operation of the valve arrangement of the sixth embodiment described inreference to FIGS. 11a-11f is more particularly illustrated in referenceto FIGS. 11c -11 e.

FIG. 11c illustrates the operation of the valve arrangement duringexpiration of the patient. Such valve arrangement can be controlled witha device (e.g. as illustrated in FIG. 11f , or more generally in aschematic manner in FIG. 3, or even more generally in any type ofbreathing assistance device with control means for controlling theoperation of the valve through an adapted electric powering of the coils11321, 11322).

During such expiration phase, the coils are controlled so as to bringthe moving part of the valve arrangement (by attraction of the magnet11360) in an axial position which closes the holes 11380—thus preventingair to flow through the channels 11350.

In such position of this moving part, the blower cannot send any air to(or receive any air from) the patient.

On the other hand, the proximal end of the valve housing 112 is providedwith apertures 1121 which allow the flow expired by the patient to exitto the atmosphere in this position of the moving part.

Indeed, in this position the moving part is blocking the communicationbetween the gas source (blower) and the patient but still allowsexpiration through the apertures of the valve housing.

In this position the air expired by the patient cannot flow towards thegas source (blower) and thus there is no risk of pollution of the blowerelements (or of the duct if there is any between the valve and the gassource).

It is also to be noted that this allows using a blower which is operatedin a constant mode (i.e. the rotor of the blower turns at a constantspeed). This can be advantageous because it can be desired in someconfigurations to have a blower operated in such constant mode—whichkeeps the operation of the blower very simple—while regulating the flowonly with the valve (instead of varying the speed of the rotor of theblower).

This also allows avoiding “losing” gas from the blower since no gas canflow through the valve from the blower. And if there is a secondary gassuch as oxygen this reveals advantageous since it is economical.

This position of the moving part also corresponds to a referenceposition of this moving part submitted only to the action of the spring1133 (i.e. when the coils are not powered).

In FIG. 11d , the moving part is controlled (always by the selectiveelectric alimentation of the coils) so as to:

-   -   keep the gas source isolated from the patient (the holes 11380        are liberated but the channel 11350 remains blocked),    -   while also blocking the evacuation of air through the apertures        1121.

This is obtained by the controlled position of the moving part (alongthe longitudinal axis A).

In this mode, the moving part can be translated by selectivealimentation of the coils so as to selectively allow a controlledleakage through the apertures 1121 (i.e. by moving the moving parttowards the distal end of the valve—towards the right-hand side of FIG.11—so as to open in a controlled manner the leakage apertures 1121).During such controlled opening of the apertures 1121 the channel 11350remain blocked and a PEP regulation is provided through the controlledleakage through the apertures 1121.

FIG. 11e illustrates a configuration where the position of the movingpart is selectively controlled so as to open the channel thereforeallowing gas flowing from the blower to the patient through the innerspace of the valve. In this configuration the apertures 1121 are alsoclosed.

It is possible to finely control the position of the moving part of suchvalve arrangement, in, real time, so as to adapt at any time the aircommunication between the gas source and the patient through the channel11350, with the opening of the proximal outlet 11351 of the channel11350.

Operation of the Device when the Gas Source is Disabled

When the gas source S is disabled, e.g. when it breakdowns, the patientP must however be able to breathe. The gas regulating valve according tothe invention allows the patient P to breathe normally in such a case.

The controller of the breathing assistance device will namely operatethe gas regulating valve so that the leakage orifice remains opened orat least partially opened during both inspiration and expiration phases.

During the expiration phase, the patient P will namely be able to expirethrough the gas regulating valve as in normal operation of the breathingassistance device.

Indeed, during expiration phases the pressurized gas, coming from thegas source, has only a role for controlling the PEP. However thecontroller allows a very precise and real time control of the opening ofthe leakage orifice through the control of the obstruction element.Therefore the absence of pressurized gas coming from the gas source canbe counterbalanced in specifically operating the opening of the leakageorifice.

The inspiration phase is also possible as the leakage orifice of the gasregulating valve is opened and allows a gas flow between the inside andthe outside of the gas regulating valve. Therefore the patient P will beable to inspire air from the atmosphere through the leakage orifice ofthe gas regulating valve.

Operation of the Device when the Controller is Disabled

When the controller is disabled, e.g. when the controller breakdowns,the obstruction means cannot be controlled anymore. Therefore a returnis provided within the gas regulating valve so that the leakage orificeremains opened in the absence of signal from the controller.

The leakage orifice of the gas regulating valve remaining opened whenthe controller is disabled, the patient P can both inspire and expirethrough the leakage orifice of the gas regulating valve.

However, the opening of the leakage orifice being not controllable, itwill not be possible to control the PEP anymore.

The gas regulating valve (40;50) of the first and second embodimentscomprise a return that consists in the metallic toric sheath (441,541)and the toric magnet (444,544). The toric magnet (444,544) beingcoaxially disposed within the metallic toric sheath (441,541), thisnaturally defines a magnetic equator M_(E).

Indeed, as illustrated in FIG. 7c , the toric magnet 73, in the absenceof signal from the controller, remains located in the centre of themetallic toric sheath 74 because of the magnetic forces operatingbetween the toric magnet 73 and the metallic toric sheath 74. The plandefined by the position of the toric magnet 73 is the magnetic equatorM_(E).

The obstruction element 72 of the gas regulating valve is preferablyshaped so that the leakage orifice 71 is widely opened when thecontroller is disabled, that is when the toric magnet 73 of theobstruction element 72 is located on the magnetic equator M_(E).

The gas regulating valve 60 of the third embodiment of the inventionalso comprises a return. This return comprises the spring 626 and thescrew 627.

As illustrated in FIGS. 6d and 6e , the spring 626 is a compressionspring. This compression spring 626 is compressed when the controllercontrols the coil 621 so that the magnetic element abuts against thecircular ridge of the first aperture 614, that is when the leakageorifice is closed (as illustrated in FIG. 6d ).

If the controller is disabled, the magnetic element will not beconstraint by the coil 621 anymore and is therefore able to translatefreely in the toric space 6227. The magnetic element being howevercoupled with the compression spring 626 via the magnet guide 623, thecompression spring 626 draws the magnetic element against the top discof the armature 622.

In case the controller is disabled, the compression spring 626 willtranslate the magnetic element of the obstruction element 62, havingtherefore a leakage orifice widely opened (as illustrated in FIG. 6e ).

Finally, as already explained, a return means is also foreseen withinthe gas regulating valve according to the fourth and fifth embodiments,this return being embodied by the membrane 925.

Indeed, the membrane 925 is made in a material with a high resilience.The specific form of the membrane 925, and in particular the use of abellows 9255 having a convex curvature oriented towards the walls of thevalve. Indeed, if the controller 35 are disabled, the coil 921 is notconstraint anymore, but the natural resilience of the material inaddition to the specific form of the membrane 925 will cause the pusherelement 927 and the coil 921 attached therewith to move back to aposition where the leakage orifice 931 are not obstructed anymore. Onceagain, the patient P will thus be able to breathe freely through thevalve.

Further, the pressure within the duct enhances the returns function ofthe membrane 925 because of its particular design. Indeed, the innerpressure, and more particularly the inspiratory pressure, deforms themembrane 925 in a way that further maintains the coil 921 in itsposition where the leakage orifice 931 is opened. The bellows 9255 aremore precisely deformed in a way that draws the cylindrical portion 9253and the annular portion 9251, so that the pusher element 927 is furthermaintained in the open position.

In the case of the valve arrangement of FIG. 11 the moving part comes inthe reference position illustrated in FIG. 11c when the coils are notpowered.

Operation of the Device when Both the Gas Source and the Controller areDisabled

In this case, the patient P will be able to breathe thanks to the returnprovided in the gas regulating valve. Indeed it has been seen above thatthe gas source S does not provide a solution for the breathingassistance device to be operated when the controller is disabled.

Therefore, when both the gas source and the controller are disabled, thebreathing assistance device according to the invention is operated inthe same way as when only the controller is disabled.

The reader will have understood that many modifications may be madewithout going beyond the new information and the advantages describedherein. Consequently, all modifications of this type shall be within thescope of breathing assistance device and methods as defined in theattached claims.

The invention claimed is:
 1. A gas regulating valve for use with abreathing assistance device, adapted to be interposed in a gastransmission duct of the breathing assistance device at a locationproximal to a patient, and comprising: a casing having a proximalportion and a distal portion that are coaxially coupled together andcomprise a passage therethrough to allow a supply of pressurized gas tocirculate from a gas source to a patient in use; a leakage orifice toatmosphere formed in the proximal portion; an obstruction elementincluding a movable element coupled to an obstructing piece capable ofvarying the opening of the leakage orifice; and a controller to controlthe movement of the obstruction element, wherein, the movable elementsurrounds the passage and is constructed to be sealingly separated fromthe supply of pressurised gas in the passage during use.
 2. The valveaccording to claim 1, wherein the obstructing piece is an elasticmembrane.
 3. The valve according to claim 2 wherein the elastic membraneis made from rubber or silicone.
 4. The valve according to claim 2,wherein the elastic membrane seals the movable element from the passage.5. The valve according to claim 1 wherein the obstruction element is anelectromagnetic obstruction element.
 6. The valve according to claim 5,wherein the obstruction element further includes a magnetic element andthe movable element is a coil and the coil surrounds the magneticelement.
 7. The valve according to claim 6, wherein the obstructionelement comprises a metallic armature that is fixed coaxially within thedistal portion.
 8. The valve according to claim 7 wherein the armaturecomprises an inner cylindrical portion and an outer cylindrical portioncoupled together by an annular portion, the inner cylindrical portionhaving a diameter smaller than the outer cylindrical portion.
 9. Thevalve according to claim 8, wherein the movable element is locatedwithin the outer cylindrical portion of the armature and translatabletherein.
 10. The valve according to claim 8, wherein a magnetic elementis fixed to the inner cylindrical portion of the armature and isconfigured to control the movement of the moveable element.
 11. Thevalve according to claim 8, wherein the inner cylindrical portion of thearmature formed part of the passage for the supply of the pressurizedgas.
 12. The valve according to claim 8 wherein the proximal end of theouter cylindrical portion includes an annular ridge adapted to couple tothe obstruction piece.
 13. The valve according to claim 2, wherein theobstructing piece includes a pusher element adapted to deform themembrane to vary the opening of the leakage orifice.
 14. The valveaccording to claim 1 further comprising at least one sensor for sensingflow and/or pressure in the gas passage, the sensor being associatedwith the controller.
 15. The valve according to claim 14, wherein thedistal portion includes an external chamber adapted to receive the atleast one sensor.
 16. The valve according to claim 15, furthercomprising a processing module configured to connect the sensor to thecontroller.
 17. The valve according to claim 16, wherein the processingmodule is removably connected to the casing.
 18. The valve according toclaim 17, wherein the processing module includes a clip for removablycoupling the processing module to the casing.
 19. The valve according toclaim 1 further comprising a breathing assistance device for a patientbreathing is successive cycles, each cycle being defined by at least aninspiration phase and at least an expiration phase, said breathingassistance device comprising: a gas source of respiratory pressurizedgas; a patient interface device; a gas transmission duct comprising adistal end coupled to said gas source and a proximal end adapted tocouple to the patient interface device; a controller to control theoperation of the device; wherein the gas regulating valve is interposedin the gas transmission duct near the proximal end of the gastransmission duct.
 20. A gas regulating valve for use with a breathingassistance device, adapted to be interposed in a gas transmission ductof the breathing assistance device at a location proximal to a patient,and comprising: a casing including a gas flow duct and a housing; aleakage orifice to atmosphere formed in the housing; an obstructionelement within the housing; a protection element within the housingbetween the leakage orifice and the obstruction element and theobstruction element being adapted to move in response to control by acontroller, wherein the gas flow duct includes a proximal end adapted tocouple to the transmission duct in the direction of a patient and adistal end adapted to couple to the transmission duct in the directionof a gas source, the gas flow duct configured to receive a flow ofbreathable gas between the gas source and the patient; wherein a firstside of the housing is in communication with the gas flow duct; andwherein, the obstruction element includes a movable element, the movableelement acting on the protection element to vary the opening of theleakage orifice in response to a signal from the controller, theprotection element isolating the obstruction element from the gas flowduct.
 21. The valve according to claim 20, wherein the protectionelement is a membrane.
 22. The valve according to claim 21, wherein themembrane is made from rubber or silicone.
 23. The valve according toclaim 22, wherein the housing is mounted transversally relative to thegas transmission duct.
 24. The valve according to claim 21, wherein theobstruction element is an electromagnetic obstruction element.
 25. Thevalve according to claim 24, wherein obstruction element furthercomprises a coil that surrounds the movable element and the movableelement includes a magnetic element.
 26. The valve according to claim25, wherein the obstruction element comprises a metallic armature thatis fixed within the housing.
 27. The valve according to claim 26 whereinthe armature comprises a top disc having a top circular opening; abottom disc having a larger bottom circular opening, the top disc andbottom disc being coaxially coupled together by a peripheral coaxialcylindrical portion having the same diameter as the bottom circularopening; an inner cylindrical passage extending into the bottom circularopening; and a toric space between the inner cylindrical passage andperipheral coaxial cylindrical portion.
 28. The valve according to claim27, wherein the movable element is located within toric space of thearmature and translatable therein.
 29. The valve according to claim 27,wherein the coil is fixed in a position surrounding the armature tocontrol the movement of the magnetic element.
 30. The valve according toclaim 27, wherein a peripheral edge of the protection element is coupledto the armature.
 31. The valve according to claim 20, wherein theobstruction element further comprises a return means to ensure theleakage orifice is opened in the absence of the signal from thecontroller.
 32. The valve according to claim 31, wherein the returnmeans is a compression spring.
 33. The valve according to claim 20further comprising at least one sensor for sensing flow and/or pressurein the gas passage, the sensor being located in the housing andassociated with the controller.
 34. The valve according to claim 33,further comprising a processing module configured to connect the sensorto the controller.
 35. The valve according to claim 20, furthercomprising a housing cover coupled to a second side of the housing. 36.The valve according to claim 20 further comprising a breathingassistance device for a patient breathing is successive cycles, eachcycle being defined by at least an inspiration phase and at least anexpiration phase, said breathing assistance device comprising: a gassource of respiratory pressurized gas; a patient interface device; a gastransmission duct comprising a distal end coupled to said gas source anda proximal end adapted to couple to the patient interface device; acontroller to control the operation of the device; and wherein the gasregulating valve is interposed in the gas transmission duct near theproximal end of the gas transmission duct.